Comment

Challenging the right on health and social care

By Cllr Bev Craig / Cllr Bev Craig

When the National Health Service was created, it was bold and radical, embodying the best of postwar socialism, implemented in the face of opposition and cynicism to create a new political consensus. It offered hope of a better future and put social equality and universalism at its core in seeking to address the prominent problems in society. It was not inevitable, nor was it envisaged to be static and unable to adapt and evolve to meet population changes.

We face a new crisis: social care. In October, the LGA warned that councils face a funding black-hole of £4.3bn by 2020 just to keep services at current levels, and this comes on top of renewed cuts already facing local councils. Large private providers argue they are on the verge of bankruptancy.

The Chancellor’s Autumn Statement ‘offer’ for social care was weak and disingenuous. A potential 2% council tax rise shifts the burden onto the poorest shoulders and creates significant disparity in funding based on postcode.
As a party we have talked a lot about the importance of social care, especially around better integration with health and person centred care. The debate is not just about doing the best we can with no money, but on the basic values and principles on which to build the health and social care system for future generations. It is our job on the left, to be creative, putting our values at the heart of public services.

To do that, we need to ask fundamental questions and have open debates on the way forward. Some of these questions include:

What does the future look like? With an aging population, living longer than ever before and balancing the needs of a population with stark health inequalities, how can we best deliver a responsive and integrated service?
Means testing versus universalism? Those on the right argue the social care sector, with its market freedom and means testing offers the future for the NHS. We on the left should be challenging this orthodoxy, arguing in reverse that the strength of universalism and public service in the NHS offers us a social care model of the future.

Who cares? We have to be honest; can we truly deliver a joined up health and social care system when provider’s profit margins are the concern of many. In run up to the last election, Labour talked about ‘incentivising providers to do the right thing’. Can free market principles be reconciled with caring, effective and efficient public services? If not, we need to be making a costed and coherent case for a publically provided and delivered social care service that is open and collaborative.

Who do we fund it? Rejecting the Chancellor’s focus on council tax, we need to have a debate, not just with ourselves- but with the public, the tax-payers about a fairly funded system achieved through fair taxation. The current means testing system is as broken as it is unsustainable.

We are best when we are bold and radical, combined with when we are credible and evidence-based. We are at our best when we speak about this issues that bind citizens across the country, and when we do it in a plain speaking, straight-forward way that connects with people. This isn’t an abstract debate, found only in textbooks. It touches each person’s life at some point, it is palpable, and these are the issues that people want to hear about from the Labour Party.
None of this is new; many across our party have been campaigning on this for some time. So, let’s come together and share thoughts and ideas on how our party can develop a radical health and social care blueprint fit for the 21st century.

Cllr Bev Craig is a Councillor for Burnage ward at Manchester City Council, and Chair of Manchester’s Health and Wellbeing Scrutiny Committee

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